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HomeMy WebLinkAbout4475 Balsam Streeti CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE �-- Inspection Type: L/1 �' ) ��r► r` �\�, a Job Address:�- Permit Number: a o! S D 14, 8 U� U rovc� ❑ No one available for inspection: Time 1) _ 9 (A"M1/PM Re -Inspection required: Yes No When corrections have been made, call for re -inspection at 303-2345933 Date:--?// / S9 Inspector: —T'b DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE Bulid`Rg In `Diision (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: 3"02 g - L/ a Q� o r-r— Job Address: `-/ 4 75' o )S-:� n, S Permit Number: -Q D ) $ o / S a ❑ No one available for inspection: Time JQ = -,913 A�M Re -Inspection required: Yes No When corrections have been made, call for re -inspection at 303-234-5933 Date: Inspector: 7T71b DO NOT REMOVE THIS NOTICE M K /-19- 41 s i CITY OF WHEAT RIDGE tom. n ` Buirding Inspectiobi�rision (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: -3c),;>- o a l ( ---, L Job Address: N Ll -7 5— F > c, is u n, Permit Number: -,P 0 ) s D l 1 S a ❑ No one available for inspection: Time I -- $—) A Re -Inspection required: S No When corrections have been made, call for re -inspection at 303-234-5933 Date: 6, 1 g Inspector: —T -b DO NOT REMOVE THIS NOTICE fm t ons City of Wheat Ridge Yr.. E -Res. Siding Replacement PERMIT - 201801682 PERMIT NO: 201801682 ISSUED: 06/08/2018 JOB ADDRESS: 4475 Balsam ST EXPIRES: 06/08/2019 JOB DESCRIPTION: Install 3 squares of D4.5 Dutchlap vinyl siding to front and back of the home per manufacturer&#39;s specifications. *** CONTACTS *** OWNER (720)376-0438 Dillon Marjorie/Jeanie Moszer SUB (770)433-8211 Gary Cummings 170102 Home Depot U.S.A., Inc. *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2406 / BEL AIRE,HILLCREST HEIGHTS, ME BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 2,728.00 FEES Total Valuation 0.00 Use Tax 57.29 Permit Fee 93.35 ** TOTAL ** 150.64 *** COMMENTS *** *** CONDITIONS *** **A MID -INSPECTION IS REQUIRED FOR HOUSE WRAP PRIOR TO SIDING INSTALLATION. A final inspection is required at completion. Work shall comply with 2012 IRC and ordinances adopted by the City of Wheat Ridge. Work is subject to field inspections. A mid -inspection is required for house wrap prior to siding installation. A final inspection is required at completion. City of Wheat Ridge E -Res. Siding Replacement PERMIT - 201801682 PERMIT N0: 201801682 ISSUED: 06/08/2018 JOB ADDRESS: 4475 Balsam ST EXPIRES: 06/08/2019 JOB DESCRIPTION: Install 3 squares of D4.5 Dutchlap vinyl siding to front and back of the home per manufacturer&#39;s specifications. I, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications, applicable building codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized by the legal owner of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with this ermrt. I further attest that I am legally authorized to include all entities named within this document as parties to the work to be performed and that all work to be performed rs disclosed in this document and/or its' accompanying approved plans and specifications. Signature of OWNER or CONTRACTOR (Circle one) Date 1. This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures. 2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building Official and may be subject to a fee equal to one-half of the original permit fee. 3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard requirements, fees androcedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of the Chief Building Official and is not guaranteed. 4. No work of any manner shall be performed that shall results in a changeof the natural flow of water without prior and specific approval. 5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services Division. 6. The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, any violation of any provision of any applice code or any frdmance or regulation of this jurisdiction. Approval of work is subject to field inspection. Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. City Of �/' `7`I heat Pidge muNrry DEVELOPMENT Building & Inspection Services Division 7500 W. 29'h Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 Inspection Line: 303-234-5933 Email: hermits aDci.wheatr idge.co.us FOR OFFICE USE ONLY Date: / Plar✓Permit # C,d �Z Plan Review Fee: Building Permit Application *** Please complete all highlighted areas on both sides of this form. Incomplete applications may not be processed. I Property Address: 4475 Balsam St, Wheat Ridge, CO 80033 Property Owner (please print): Jeanie Moszer Phone: 720 376-0438 Property Owner Email: Mailing Address: (if different than property address) Address: City, State, Zip: Architect/Engineer: Architect/Engineer E-mail: Phone: Contractor: Home Depot USA Contractors City License #: 170102 Contractor E-mail Address: Jamie reedysetgo.com Sub Contractors: Phone: 801 710-2507 Electrical: Plumbing: Mechanical: W.R. City License # W.R. City License # W.R. City License # Other City Licensed Sub: Other City Licensed Sub: City License # City License # Complete all information on BOTH sides of this form ❑ COMMERCIAL RESIDENTIAL Description of work: (Check all that apply) ❑ NEW COMMERCIAL STRUCTURE ❑ ELECTRICAL SERVICE UPGRADE ❑ NEW RESIDENTIAL STRUCTURE ❑ COMMERCIAL ROOFING ❑ COMMERCIAL ADDITION ❑ RESIDENTIAL ROOFING ❑ RESDENTIAL ADDITION ❑ WINDOW REPLACEMENT ❑ COMMERCIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.) ❑ RESIDENTIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.) ❑ MECHANICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT ❑ PLUMBING SYSTEM/APPLIANCE REPAIR or REPLACMENT ❑ ELECTRICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT ❑ OTHER (Describe) (For ALL projects, please provide a detailed description of work to be performed, including current use of areas, proposed uses, square footage, existing condition and proposed new condition, appliance size and efficiency, type and amount of materials to be used, etc.) Sq. Ft.ILF Amps Install 3 squares of D4.5 Dutchlap vinyl siding to front and back of the home, per manufacturer's specification. Btu's Gallons Squares Other Project Value: (Contract value or the cost of all materials and labor included in the entire project) $ 2728.00 OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT I hereby certify that the setback distances proposed by this pemrit application are accurate and do not violate applicable ordinances, rules or regulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown and allegations made are accurate; that I have read and agree to abide by all conditions printed on this application and that I assume full responsibility for compliance with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application; that I am the legal owner or have been authorized by the legal owner of the property to perform the described work and am also authorized by the legal owner of any entity included on this application to list that entity on this application. 1, the applicant for this building permit application, warrant the truthfulness of the information provided on the application. CIRCLE ONE: (OW.IVER) (CONTRACTOR) or (AUTHORIZE -a EPRESEA'TATIVE) of (OWNER) (CONeACTOR) Electronic Signature (first and last name): t �& DATE: 6/6/18 ZONING COMMMENTS: Reviewer: BUILDING DEPARTMENT COMMENTS Reviewer: DEPARTMENT USE ONLY OCCUPANCY CLASSIFICATION: Building Division Valuation: # l� 2b) � 55' h A VY---1 Lagenia Reimer VO 1 D *FePM l T From: Jeremy Wiles <jwiles@interstateroof.com> Sent: Friday, June 8, 2018 10:00 AM To: CommDev Permits Subject: 201708931 Categories: Gina Please cancel our roofing permit for 10370 W 35th Ave. The customer cancelled, we never roofed the house. Thanks, Jeremy Wiles Interstate Roofing M A i CITY OF WHEAT RIDGE T" Building Inspection=Dfrision (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE InspectionType: izvU'� Job Address: Permit Number: 2 c,1 i -7 0 z 4_ SS ❑ No one available for inspection: Time ' ` 'AM/PM Re -Inspection required: Yes N__ When corrections have been made, call for re -inspection at 303-234-5933 Date: (-, ' -7 , / �- Inspector: DO NOT REMOVE THIS NOTICE Lagenia Reimer From: Carrie Nordlund <cnordlund@mrpprogram.com> Sent: Thursday, April 12, 2018 1:11 PM To: Lagenia Reimer Subject: Permits under Armor LLC Lagema, Thank you for taking the time to speak with me today regarding the open roof permits pulled by Armor LLC. As we discussed, Armor was contracted through the MadSky Managed Repair Program on several roofs but the company (Armor LLC) has since dissolved due to the owner loosing a leg in a motorcycle accident so we have assigned another one of our contractors (Bear Brothers Roofing) to finish out the permits on the jobs. Please allow them to pull job cards, schedule final roof inspections, and whatever else is needed on the following jobs in Wheat Ridge: • 4525 Flower Street (Patrick Bigley, Mary Carver) )( Z110622`l • 4475 Balsam Street (Marjorie Dillon, Jeanie Moszer)%, • 6185 West 30th Avenue (Bryce & Norma Tourmer), 2 • 4580 Upham Street (Elizabeth & Evan Templeton) 2-'013 6 • 3690 Jay Street (Clifford & Carolyn Randall))( 20 170 47 20 Please feel free to contact me with any questions or problems. Thank you again for your assistance in this matter. Carrie KADSKY MANAGED REPAIR PROGRAM Carrie Nordlund - Quality Control Specialist (C) 773-780-7818 MadSky Managed Repair Program 365 Inverness Pkwy, Suite 150 Englewood, CO 80112 http://www.madskymrp.com/ This email, along with any attachments, is for the sole use of its intended recipient, and may contain confidential information or information that is otherwise protected from disclosure. If you are not the intended recipient, or if you have received this message in error, please delete this message; you may not copy or disclose its contents to anyone. i CITY OF WHEAT RIDGE _:�9�Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office - (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: /t c F Job Address: 'Itl % S Permit Number: 'I U/ 7U7 Cd S F r/VU OP 44) 1_367 h ❑ No one available for inspection: Time "y (A /PM Re -Inspection required: Yes N When corrections have been made, call for re -inspection at 303-234-5933 iI p � Date: � 1�' 7/ ' % Inspector: / DO NOT REMOVE THIS NOTICE City of Wheat Ridge Residential Roofing PERMIT - 201702455 *** COMMENTS *** *** CONDITIONS *** Effective December 1, 2014, asphalt shingle installations require an approved midroof inspection, conducted when 25-75 percent of the roof covering is installed, prior to final approval. Installation of roof sheathing (new or overlay) requires an approved inspection prior to installation of ANY roof coverings and is require on the entire roof when spaced or board sheathing with ANY gap exceeding A;�-inch exists. Asphalt shingles are required to be fastened to the roof deck with a minimum of 6 nails per shingle. Ice and water shield is required. Eave and rake metal is required. A ladder extending 3 feet above the roof eave and secured in place is required to be provided for all roof inspections. Roof ventilation is required to comply with applicable codes and/or manufacturera€'"s installation instructions, whichever is more stringent. In order to pass a final inspection of elastomeric or similar type roof coverings, a letter of inspection and approval from the manufacturer&#39;s technical representative stating that "the application of the roof at (project address) has been applied in accordance with the installation instruction for (roof material brand name) roof covering" is required to be on site at the time of final inspection. PERMIT NO: 201702455 ISSUED: 06/23/2017 JOB ADDRESS: 4475 Balsam ST EXPIRES: 06/23/2018 JOB DESCRIPTION: Residential Re -roof to install Tamko Heritage asphalt shingles 28 sq. *** CONTACTS *** OWNER (720)376-0438 MOSZER JEANIE SUB (720)383-4660 Glenn Renner 170262 Armor LLC *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2406 / BEL AIRE,HILLCREST HEIGHTS, ME BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 8,463.00 FEES Total Valuation 0.00 Use Tax 177.72 Permit Fee 188.45 ** TOTAL ** 366.17 *** COMMENTS *** *** CONDITIONS *** Effective December 1, 2014, asphalt shingle installations require an approved midroof inspection, conducted when 25-75 percent of the roof covering is installed, prior to final approval. Installation of roof sheathing (new or overlay) requires an approved inspection prior to installation of ANY roof coverings and is require on the entire roof when spaced or board sheathing with ANY gap exceeding A;�-inch exists. Asphalt shingles are required to be fastened to the roof deck with a minimum of 6 nails per shingle. Ice and water shield is required. Eave and rake metal is required. A ladder extending 3 feet above the roof eave and secured in place is required to be provided for all roof inspections. Roof ventilation is required to comply with applicable codes and/or manufacturera€'"s installation instructions, whichever is more stringent. In order to pass a final inspection of elastomeric or similar type roof coverings, a letter of inspection and approval from the manufacturer&#39;s technical representative stating that "the application of the roof at (project address) has been applied in accordance with the installation instruction for (roof material brand name) roof covering" is required to be on site at the time of final inspection. City of Wheat Ridge Residential Roofing PERMIT -201702455 PERMIT NO: 201702455 ISSUED: 06/23/2017 JOB ADDRESS: 4475 Balsam ST EXPIRES: 06/23/2018 JOB DESCRIPTION: Residential Re -roof to install Tamko Heritage asphalt shingles 28 sq. I, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications, applicable building codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized by �heJAal0"cr0fthee property and am authorized to obtain this permit and perform the work described and aroved in conjunction with thiserm t- I+furtherattest that I am legally authorized to include alt entities named within this document as parties to thework to be perrmed and that all wr__perfoimed is disclosed in this document and/or its' accompanying approved plans and specifications. Signature OF OWNED or CONTRACTOR (Circle one) Date I . This permit was issued based on the information provided in thepennit application and accompanying plans and specifications and is subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, po plans and procedures. 2. This. permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building Official and may be subject to a fee equal to one-half of the original permit fee. 3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard requirements, fees and procedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of the Chief Building Official and is not guaranteed. 4. No work of any manner shall be performed that shall results in a change of the natural flow of water without prior and specific approval. 5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services Division. 6. The issuance or granting of a permit shall not be construed to be a pen -nit for or an approval of, any violation of any provision of any applicable code or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection. Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. Inspection time requests will be accepted by email only. Please email requests to insptimerequest@ci.wheatridge.co.us between 7:30am and 8:00am, the morning of the inspection. Please put the address of the inspection in the subject line. Antoinette Kulick (% ()�)-C/ss- From: no-reply@ci.wheatridge.co.us Sent: Tuesday, June 13, 2017 3:21 PM To: Permits CommDev Subject: Online Form Submittal: Residential Roofing Permit Application Residential Roofing Permit Application This application is exclusively for new permits for residential roofs and for licensed contractors only. This type of permit is ONLY being processed online --do not come to City Hall to submit an application in person. Permits are processed and issued in the order they are received. YOU WILL BE CONTACTED WHEN YOUR PERMIT IS READY FOR PICK-UP AND WILL BE GIVEN A SPECIFIC DATE AND TIME WINDOW TO COMPLETE THE TRANSACTION. You will be notified if your contractor's license or insurance has expired, and you may update those documents at the time you are issued your permit. Permits are currently being processed within 3-5 business days, subject to change based on volume. For all other requests: Homeowners wishing to obtain a roofing permit must apply for the permit in person at City Hall. Revisions to existing permits (for example, to add redecking) must be completed in person at City Hall. All other non -roofing permits must be completed in person at City Hall. The Building Division will be open from 7:30-10:30 a.m., Monday through Friday to process these types of requests. THIS APPLICATION DOES NOT CONSTITUTE A PERMIT. DO NOT BEGIN REROOFING UNTIL PERMIT HAS BEEN ISSUED. Is this application for a Yes residential roof? How many dwelling units Single Family Home are on the property? PROPERTY INFORMATION Property Address Property Owner Name Property Owner Phone Number Property Owner Email Address 4475 Balsam St Jeanie Moszer 720-376-0438 jmoszer91 @hotmail.com c�- Do you have a signed Yes contract to reroof this property? It will need to be provided at the time of permit pick-up. CONTRACTOR INFORMATION Contractor Name Armor LLC Contractor's License 170262 Number (for the City of Wheat Ridge) Contractor Phone 720-383-4660 Number Contractor Email Address billing.armorllc@gmail.com (permit pick-up instructions will be sent to this email) Retype Contractor Email billing.armorllc@gmail.com Address DESCRIPTION OF WORK Are you re -decking the No roof? Description of Roofing Asphalt Shingles: Tamko Heritage Material Select Type of Material: Asphalt If "Other" is selected Field not completed. above, describe here: How many squares of the 28 material selected above? Does any portion of the No property include a flat roof? If yes, how many squares Field not completed. on the flat roof? 0) TOTAL SQUARES of all roofing material for this proj ect Provide additional detail here on the description of work. (Is this for a house or garage? What is the roof pitch? Etc) Project Value (contract value or cost of ALL materials and labor) 28 Remove and replace Asphalt Shingles on House and Garage, pitch 5/12 8463 SIGNATURE OF UNDERSTANDING AND AGREEMENT I assume full Yes responsibility for compliance with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application. I understand that this Yes application is NOT a permit. I understand I will be contacted by the City to pay for and pick up the permit for this property. I understand that work Yes may not begin on this property until a permit has been issued and posted on the property. I certify that I have been Yes authorized by the legal owner of the property to submit this application and to perform the work described above. Name of Applicant Glenn Renner Email not displaying correctly? View it in your browser. 3 ARMOR Rooring & Claim service. N City, ity, st ate, zip- - A& Mont. 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DO NOT REMOVE THIS NOTICE H City of Wheat Ridge Building Division 7500 W. 29 Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-235-2857 Inspection Line 303-234-5933 Property Address: Address: City, State, Zip: Contractor. M Plumbing City License #: Mechanical City License #: Company Company: Sq FtJL.Ft added: Squares — BTU's — Gallons Amps — mw��� Plan # Permit Property Address: Prope rye {please print }. Ph one. Mailing s. (if different than property address) A d d ress. City, State, Zip: EM City License # City License City License NAM a s AT r =� DATE: _' h CITY OF WHEAT RIDGE / Building Inspection Division (303) 234-5933 Inspection line ~JJ (303) 235-2855 Office - (303) 235-2857 Fax INSPECTION NOTICE ` Inspection Type: A';4 Job Address/Permit Number: ?1`-f 75 13-4I s, wy s ❑ No one available for inspection: Time 3 Vg~' AM/PM Re-Inspection required: Yes No `When corrections have been made, call for re-inspection at 303-234-5933 Date: d '3 Inspector: DO NOT REMOVE THIS NOTICE " : City of Wheat Ridge Residential Plumbing PERMIT PERMIT NO: 090370 ISSUED: JOB ADDRESS: 4475 BALSAM.. ST EXPIRES:= DESCRIPTION: 12 if sewer repair in yard CONTACTS.*** owner 303/423-0563 Dick Dillon " sub- 303/975-0005 -'Bob/Kathy-Wernly - 06-020( r10/.17/2C ibkat, Ir. PARCEL INFO ' zzP ZONE CODE: UA USE: : UA:. SUBDIVISION:.:. 0311: BLOCK/LOT#: 0/. x es FEE SUMMARY ESTIMATED PROJECT VALUATION: 3,'000 FEES t~ Permit Fee 108.30 u, Total Valuation .00 Use. Tax 54.00 **TOTAL .162.30 Conditions; Subject to field inspections. Ihereby certify that the setback distances proposed by this permit application are accurate, and do not w oldie a„p~1 ahlaa ordinances, rules or regulations of the City of Wheat Ridge or covenants, easements or restrictions of !record ~pat~dl measurements shown, and egations made are accurate; thatI have read and agreeto abide: by all conditions piin.i~✓ et t x' application and. that ume full responsibility for compliance with the Wheat Ridge Building Code (I.B applicable VX7 as, for work under this pe 't. Tans subject to field inspection. 20 fi.., Signature of ontractor/owner dat 1. This permit was issued in accordance with the provisions set forth in your application and is subject G4 GtS~y - ~ ~ way r. ' State of Colorado and to the Zoning Regulations and Building Codes of Wheat Ridge, Colorado or any" gGites c$i71C ordinances. of the City,. 2. This permit shall expire. 180 days. from the issue date.: Requests foran extension'. date. An extension may be granted at the discretion of the Building Official:: 3. If. this. permit. expires, ..a new permit may be acquired for a fee of one-half thea changes have. been or will be made in the original plans and specifications and an exceeded one (1) year. If changes. have been or if suspension or abandonment axe. be paid for a new permit. 4. No work of any manner shall be done that will change the natural flow of water cal 5.: Contractor shall notify the Building Inspector: twenty-four -(24)hours in advance:' written approval: on inspection card before proceeding with successive phases of '.t [,N( G- WEAT RIDGE 67 The issuance of a permit or the approval of drawings: and specifications shall not 2;01 PIN Cdba an. approval' of, any violation of the provisions of the building codes or any othe A11. plan review is subje to field inspections. { HPI or GORY ',Err T r-1 d0 CN100140D AMOUNT Signature of Chief B Official date N~rSF Li' if Sewer reGd1'r '1 162.30 0f .s70 INSPECTION RE EST LINE: (303)234-5933 BUILDING OFFICE:' Pe fifd'~ Fee 10&.30 REQUESTS MUS. BE MADE BY 3PM ANY BUSINESS DAY FOR INSPECTION Use Tax 54.00 PA;i,;.r,'T RECEIVED MOUNT - ;.003 162.30 de; Ai. 162.30 oFW"E9' City of Wheat Ridge Building Division °m 7500 W. 29th Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-235-2857 ` ~ocoen~o Inspection Liner-303-234-5933 Building Permit Application Date: Plan Permit O W~31C) s!aP?]%~~?~ _T(~7Fi ALA S'I . Property Owner (please print): IGZ a Phone: :31 q-gS- 0563 Mailing Address: (if different than property address) Address: City, State, Zip: : - BOSKAT, intc . Contractor License ~o0~00 Phone: 3!975-~5 N INN N,dG . w Electrical City License Plumbing City License Mechanical City, License* Company: Company Company: Exp. Date: Exp. Date: Exp. Date: Approval: Approval: Approval: Use df s ace d'escri tion)` Construction Value: 3.000 (as. calculated per the Building aluatipn Data sheet) EXCr.V/~TtO>`M ,1A ~fA9,0 Plan Review (due at time of submittal): $ FOR sWER sERy IcE `~Pn1R. Sq. Ft./L.Ft added: Squares BTU's Gallons Amps OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT I hereby certify that the setback distances proposed by this permit application are accurate, and do not violate applicable ordinances, rules or regulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown, and allegations made are accurate; that I have read and agree to abide by all conditions printed on this application and that l assume full responsibility for compliance with the Wheat Ridge Building Code (I.B.C) and all other applicable Wheat Ridge Ordinances, for work under this permit. Plans subject to ection: C/RLCE ONE:: (OWNER) (CONTRACTOR) or PERSONAL REPRESENTATIV of ER) (CONTRATOR) PRINT NAME: GMEQ 0, SIGNATURE: Date: